VISCERAL LEISHMANIASIS AT THE AIDS TIME - CLINICAL-FEATURES

Since ten years, an increasing number of Visceral Leishmaniasis has be en reported in mediterranean countries (principally in Spain and South ern France), owing to AIDS outbreak. Mediterranean kala-azar, which wa s known as an infant disease, has been found more and more frequently in adults. Despite that clinical manifestations are generally similar to classical descriptions, new atypical features due to AIDS are somet imes observed. Specific antibodies are positive in only one third of c ases, but Leishmania amastigotes are easily found in bone marrow and o ther specimens like blood, liver, skin and lung. Lethality and relapse s are frequent. Visceral leishmaniasis may be also observed in other i mmunocompromised situations. In immuno-competents, chronic asymptomati c infections have been reported in Brasil. Acquired cellular immuno-de ficiency allows to Leishmania donovani to express its virulence, thus explaining its opportunistic role in AIDS.